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Information × Registration Number 0214U005891, 0110U003079 , R & D reports Title Method optimization for the treatment of patients with endotoxemia in the practice of intensive care. popup.stage_title Head Konovchuk Victor Mikolaevich, Registration Date 12-01-2015 Organization Bukovinian State Medical University popup.description2 The object of the research: 1) a study of the effect of combined use of plasmapheresiswith reosorbilacton the body of patients with purulent-septic complications in resuscitation and intensive care departments (60 pers.); 2) an advanced study of pathogenetic mechanisms of chronic sinusitis in children and predicting the risk of complications (135 children); 3) a study of the clinical course features, diagnosing and treatment of surgical diseases of caecum iliac segment (719 children). Objective - 1) to improve the quality of care for people with endotoxemia caused by purulent-septic complications by applying a combination of discrete plasmapheresis and infusion of sorbilact; 2) to improve diagnosing and treatment of chronic sinusitis by identifying key factors of chronic inflammation, risk factors for complications and prediction of their occurrence; 3) to improve the results of treatment of children with surgical diseases of caecum iliac segment in children by grounding pathogenesis and improving diagnosing and methods of surgical correction. Research methods and equipment - general clinical, biochemical, ENT, genetic research, radiological (irrigography, irrigoscopy, computed tomography), endoscopic (esophagoduodenoscopy, fibrocolonoscopy, sigmoidoscopy), histochemical (determination of tissue acetylcholinesterase activity) experimental (modeling and correction of caecum ileac segment diseases in rats), macroscopic, histological and microscopic, morphological (a study of morphological changes of the bowel wall and of the APUD-system), intraoperative (intraoperative manometry) and statistical ones. Theoretical and practical results: 1) It has been established that the discrete plasmapheresis combined with sorbilact infusion in patients with purulent-septic complications activates osmoregulatory, volumoregulatory and detoxificationkidney function; it effects positively on the condition of the central and peripheral hemodynamics. We developed and proposed a new approach to the treatment of septic complications which had been pathogenetically justified. 2) It has been established that chronic sinusitis in children is associated with mutations in genes of interleukin 4 and 1?, which encode the structure of proteins involved in key mechanisms and in control systems of inflammatory response of the upper respiratory tract. It has been proved that the reduction in production of IL-1? by10,1-18,3% is a marker of risk for progression of exudative inflammation of the paranasal sinuses, and an increase of the synthesis of IL-4 by 8,1-41,5% is a risk factor for the onset of chronic polypous sinusitis in children. We developed and suggested new ways of early diagnosing and prediction of severe chronic inflammation of the nasal cavity and paranasal sinuses in children. 3) While studying the regularities of clinical course of caecum ileac segment disease from the position of a comprehensive approach to their origin we established that a damage to one of the structures of this area leads to a damage of the segment as a whole. The main clinical signs and priority additional methods in a number of diseases have been determined. We have developed differential diagnostic tables and algorithms of examination and treatment of children with diseases of the caecum iliac segment that contribute to timely diagnosis, limiting unwarranted surgical interventions, of choosing an adequate surgical treatment. Novelty: 1) We were the first to study the influence of discrete plasmapheresis combined with infusion of sorbilact on renal function, on endotoxemia rate, on the condition of the central and peripheral hemodynamics in patients with systemic inflammatory response syndrome and in patients with endotoxemia caused by purulent-septic complications. 2) For the first time in Ukraine the analysis of the impact of point mutations in genes IL-1? (C-511T) and IL4 (C-590T) on the pathogenetic links of chronic sinusitis progression in children has been made. It was established that the CC genotype of the gene IL-1? and C-allele of IL-4 gene is associated with more frequent chronic inflammation and purulent exudation in the prevalence of paranasal sinuses. CT genotypes of IL-1? and IL-4 genes are risk factors for increased incidence and severity of chronic polypous sinusitis in children. 3) For the first time we have studied some regularities in the clinical course of the caecum ileac segment disease in children from a position of integrated approach to their origin: a damage to one of the structures of caecum ileac segment leads to a lesion of the segment as a whole. The effectiveness of implementation. The result of our work: 410 scientific papers, 5 monographs, 11 tutorials, 19 patents; 10 innovations. Sector (field) of use: medicine - anesthesiology and intensive care, pediatric surgery, otolaryngology. Product Description popup.authors Акентьєв Сергій Олександрович Боднар Борис Миколайович Боднар Олег Борисович Ватаманеску Лівій Іванович Калуцький Ігор В'ячеславович Кифяк Петро Васильович Ковтун Анатолій Іванович Кокалко Микола Миколайович Коновчук Віктор Миколайович Левицька Світлана Анатоліївна Мазур Ольга Олександрівна Плаксивий Олександр Григорович Ротар Василь Іванович Сапунков Олег Давидович Сокольник Сергій Олександрович Унгурян Андрій Михайлович Яковець Кароліна Іванівна popup.nrat_date 2020-04-02 Close